Outcome of bevacizumab (avastin) injection in patients with age-related macular degeneration and low visual acuity

Objective: To study the effect of intravitreal bevacizumab for the treatment of longstanding exudative age-related macular degeneration (AMD) and low visual acuity. Methods: Forty-seven patients (48 eyes) aged 57 to 90 years with AMD for 5 months or more and visual acuity of 20/150 or less were treated with one or more injections of bevacizumab 1.25 mg/0.05 mL between December 2005 and March 2007. The files were reviewed for background data, visual acuity, fluorescein angiography, retinal thickness, and complications. Results: Thirty-two eyes were treated previously with photodynamic therapy. Mean duration of symptoms was 17.9 ± 17.5 months; mean number of bevacizumab injections was 3.41 ± 2; and mean follow-up was 27 ± 15 weeks. Snellen visual acuity improved from 20/150 to hand movements (mean logMAR 1.34 ± 0.29) to 20/50 to counting fingers (mean logMar 1.2 ± 0.42) (P = 0.003, paired t-test). Visual acuity improved by≥3 lines in 12 eyes (25%); showed no change in 9 eyes (19%); and deteriorated by ≥3 lines in 4 eyes (8.3%). Visual acuity was at least 20/150 in 16 eyes (33.3%) at the end of follow-up compared with 4 eyes (8.3%) before treatment (P = 0.02, McNemar test). Mean central retinal thickness (measured in 22 eyes) decreased from 324 ±121 μm to 264 ± 65 μm (P = 0.02, paired t-test). Conclusions: Patients with chronic exudative AMD and low visual acuity may benefit from intravitreal bevacizumab injections. RETINA 28:1302-1307, 2008